Feelings of detachment during rescue incidents: Qualitative analysis of depersonalisation and derealisation in paramedics

Abstract

Depersonalisation and derealisation (DepDer) are alterations in consciousness occurring in both healthy people and those with mental problems, including trauma-related disorders. Depersonalisation relates to emotional detachment or numbing and distorted bodily sensations. Derealisation is associated with experiencing the environment as unreal or strange. This qualitative study explores these phenomena occurring during rescue operations by paramedics. Eight women participated in-depth interviews which were transcribed and subjected to interpretative phenomenological analysis, leading to identifying seven salient themes: 1) Getting excited and alert before rescue operations, 2) Running on autopilot under stress, 3) Filtering out stimuli to avoid distraction, 4) Agitation affects the perception of time, 5) Abreactions when detachment fades, 6) Selective memory about the course of events, and 7) Dealing with loss. Results show that DepDer were functional during emergency actions. Further research is necessary into normal and pathological forms of DepDer, and examining them in terms of state and trait.